Abstract
BackgroundIncidence of ulcerative colitis (UC) in elderly population is increasing because of ageing and because of its minimal impact on life span. Data on natural history, outcomes and therapeutic strategies are limited.Our aim is to characterize UC in elderly-onset patients followed at our Inflammatory Bowel Disease outpatient clinic and compare with adult-onset UC.MethodsFrom January 2000 to June 2019, 94 patients with UC diagnosed after the age of 65 years (elderly group, E-O) were identified and matched 1–1 according to gender and calendar year of diagnosis with patients diagnosed with UC at age between 40 and 64 years (adult age, A-O).ResultsComorbidity Index (3.8 vs 1.6, p < 0.0005) was higher for elderly UC patients. Symptoms at presentation were similar between the two groups, although abdominal pain was more common in adults, and weight loss was more common in the elderly. At diagnosis, left colitis (61% vs 39%) and proctitis (14% vs 26%) (p = 0.011) were more frequent in the elderly. Therapy and clinical behaviour were similar. Surgery was more frequently performed in the elderly (20% vs 9%, p = 0.02), while biological therapy was less used (2.1% vs 22%, p < 0.0005). Complications were more frequent in the elderly. Extraintestinal manifestations were lower in elderly patients (9.6% vs 19.2%, p = 0.061). Time to first relapse was similar between the two groups. Mortality (p < 0.0005) was higher in elderly patients.ConclusionsUlcerative Colitis has similar presentation and behaviour in elderly and adults patients. However, the elderly are more fragile because of comorbidities, increased risk of infections and disease-related complications.
Highlights
Incidence of ulcerative colitis (UC) in elderly population is increasing because of ageing and because of its minimal impact on life span
Ninety-four patients with UC diagnosed after the age of 65 years were identified and matched 1–1 according to gender and calendar year of diagnosis with patients diagnosed with UC at age between 40 and 64 years
Demographic information and risk factors 94 patients who have been diagnosed with UC after the age of 65 years were compared with 94 patients who have been diagnosed with UC between 40 and 64 years
Summary
Incidence of ulcerative colitis (UC) in elderly population is increasing because of ageing and because of its minimal impact on life span. Our aim is to characterize UC in elderly-onset patients followed at our Inflammatory Bowel Disease outpatient clinic and compare with adult-onset UC. The number of patients with IBD diagnosed older than 65 years is rising. This is due to the rising incidence of IBD and to an ageing population. The aim of our study is to characterize UC diagnosed after the age of 65 years. Our primary aim is to describe clinical presentation of UC in two cohorts of patients: patients who received diagnosis of UC during adult age ( between 40 and 64) and patients who received diagnosis of UC when they were 65 or older
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